1
|
AbuMoussa S, Roshan MP, Souza FF, Daley D, Rosenberg A, Pretell J, Fullerton N, Subhawong T. Soft Tissue Masses of the Hand: A Review of Clinical Presentation and Imaging Features. Curr Oncol 2023; 30:2032-2048. [PMID: 36826119 PMCID: PMC9955517 DOI: 10.3390/curroncol30020158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 02/11/2023] Open
Abstract
More than 15% of all soft-tissue tumors arise in the hand. Because of the location of these tumors, even small abnormalities may be alarming to patients on presentation. Although the majority of lesions are benign and can be diagnosed solely by history and physical examination, additional imaging workup may be required to confirm a diagnosis or define anatomic extent of involvement. This paper aims to review the basic epidemiology, clinical presentation, imaging findings, and treatment options of the more common soft-tissue tumors of the hand.
Collapse
Affiliation(s)
- Samuel AbuMoussa
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Mona Pari Roshan
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Felipe Ferreira Souza
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Dane Daley
- Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Andrew Rosenberg
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan Pretell
- Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Natalia Fullerton
- Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Ty Subhawong
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Correspondence: ; Tel.: +1-(305)-585-7500
| |
Collapse
|
2
|
Ganglions in the Hand and Wrist: Advances in 2 Decades. J Am Acad Orthop Surg 2023; 31:e58-e67. [PMID: 36580047 DOI: 10.5435/jaaos-d-22-00105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 10/12/2022] [Indexed: 12/30/2022] Open
Abstract
Ganglion cysts represent the most common soft-tissue mass in the hand and wrist. Ganglion cysts are most commonly encountered at the dorsal or volar aspects of the wrist, although cysts may arise from the flexor tendon sheath, interphalangeal joint, and extensor tendons. Intraosseous and intraneural ganglion cysts have also been described. Diagnosis of ganglion cysts relies primarily on history and physical examination. Transillumination and aspiration of masses may be useful adjuncts to diagnosis. Imaging such as radiography and ultrasonography may be indicated to evaluate for associated conditions, such as degenerative joint disease, or to rule out a solid or heterogeneous mass. Advanced imaging such as MRI is generally reserved for patients in whom occult ganglions, intraosseous ganglions, or solid tumors, including sarcoma, remain a concern. Treatment of ganglion cysts includes observation, aspiration or puncture with possible corticosteroid injection, and surgical excision. Nonsurgical management may result in cyst resolution in over 50% of patients. Surgical excision is associated with recurrence rates of 7% to 39%. Advances in surgical techniques have allowed surgeons to conduct arthroscopic ganglion excision, with recurrence rates similar to those of open management. This study highlights the advances in diagnosis, treatment, and outcomes that have taken place over the past 2 decades for this common condition affecting the hand and wrist in the adult population.
Collapse
|
3
|
Najjaar A, Kotzé J, Solomons M, McGuire D. Percutaneous puncture of flexor sheath ganglions: an assessment of recurrence. J Hand Surg Eur Vol 2022; 47:1168-1169. [PMID: 36065115 PMCID: PMC9727109 DOI: 10.1177/17531934221115983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
4
|
Lee YK. Formation of multiple ganglion cysts along the flexor tendon after open A1 pulley release for trigger finger: A case report. Medicine (Baltimore) 2022; 101:e29663. [PMID: 35866807 PMCID: PMC9302314 DOI: 10.1097/md.0000000000029663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
RATIONALE When surgical treatment is indicated for primary trigger finger, open A1 pulley release has traditionally been recommended with generally good results. However, ganglion cysts of the flexor tendon sheath as a complication after an open A1 pulley release were rarely reported. Therefore, the purpose of this study is to report a case of multiple ganglion cysts arising from the flexor tendon sheath in a patient undergoing an open A1 pulley release for trigger finger disorder with a review of the relevant literature. PATIENT CONCERNS AND DIAGNOSIS A 65-year-old right-handed farmer was referred to our hospital for swelling in the left long finger (LLF). One year before the visit, the patient was diagnosed with trigger finger in the LLF at other hospital and an open A1 pulley release was performed, but the swelling of the finger persisted. The patient had no history of trauma or evidence of systemic disease such as rheumatoid or other inflammatory arthritis. The patient was diagnosed with multiple ganglion cysts of flexor tendon sheath after investigation. INTERVENTION AND OUTCOMES We successfully excised cystic masses and debrided the partially ruptured flexor digitorum superficialis (FDS) tendon and sutured it using 5/0 prolene. At 12-month follow-up, the patient was completely asymptomatic with excellent range of motion in the distal interphalangeal (DIP) joint (0°-60°) of his LLF, showing no recurrence of ganglion cyst. LESSONS Trigger finger is a common condition that clinicians encounter frequently. However, this familiarity may lead to inattentive treatment. Nevertheless, through this case, clinicians should devote careful attention when performing open A1 pulley release to prevent partial rupture of the flexor tendon in the A1 pulley. If ganglion cysts occur, we believe that surgical excision can yield good results.
Collapse
Affiliation(s)
- Young Keun Lee
- Department of Orthopedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University – Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea
- *Correspondence: Young Keun Lee, Department of Orthopedic Surgery, Jeonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, JeonJu 54907, Republic of Korea (e-mail: )
| |
Collapse
|
5
|
Akkus G, Karagun B, Çetinalp NE, Açıkalın A, Evran M, Sengöz S, Sert M, Zorludemir S, Tetiker T. Clinical Relevance and Immunohistochemical Patterns of Silent Pituitary Adenomas: 10 Years of Single-centre Experience. Curr Med Imaging 2021; 17:310-317. [PMID: 33357196 DOI: 10.2174/1573405616666201223125642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Silent pituitary adenomas are clinically non-functional (i.e., without clinically evident pituitary hormone production). INTRODUCTION The aim of this study was to investigate subjects with silent pituitary adenomas for possible variations in their clinical status. METHODS A total of 102 patients who had undergone surgery for pituitary adenoma and had been diagnosed with silent pituitary adenoma was included in the study. The patients' preoperative and postoperative hormonal parameters and magnetic resonance imaging (MRI) features were collected, and pathological specimens were re-evaluated. RESULTS Immunohistochemistry results of the 102 patients were as follows: hormone-negative adenomas (n=35) 35.5%; FSH+LH-positivity (n=32) 31.3%; ACTH-positivity (n=11) 10.7%; α-subunit- positivity (n= 9) 8.8%; prolactin-positivity (n=8) 7.8%; GH-positivity (n=6) 5.4%; and plurihormonal adenoma (n=1). The mean sizes of SGA, SGHA, and SCA were 28.0±12.7, 30.0±16.0, and 27.7±8.9mm (p>0.05), respectively. With the exception of silent gonadotroph adenomas (SGAs), female gender dominance was shown in patients with silent growth hormone adenoma (SGHA) and silent corticotroph adenoma (SCA). Although no clinical relevance was observed in relation to hormonal excess, preoperative GH (4.21±4.6, vs. 0.27±0.36 p=0.00) was slightly more elevated in SGHA than in GH-negative adenomas. Additionally, preoperative basal ACTH values (47.3±28.7 vs. 23.9±14.4, p=0.003) were also higher in SCA compared to the other types. Our findings revealed SCAs to be of more aggressive behaviour than SGHAs and SGAs due to invasiveness in radiological imaging, their elevated re-operation, and postoperative ACTH values. CONCLUSION Silent pituitary adenomas represent a challenging diagnostic tumour group. Careful initial evaluation of patients with pituitary adenomas should consider any mild signs and symptoms of functionality, particularly in cases of GH- and ACTH-secreting adenomas.
Collapse
Affiliation(s)
- Gamze Akkus
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| | - Barış Karagun
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| | - Nuri E Çetinalp
- Cukurova University, Faculty of Medicine, Division of Neurosurgery, Adana, Turkey
| | - Arbil Açıkalın
- Cukurova University, Faculty of Medicine, Divison of Pathology, Adana, Turkey
| | - Mehtap Evran
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| | - Sinem Sengöz
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| | - Murat Sert
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| | - Suzan Zorludemir
- Cukurova University, Faculty of Medicine, Divison of Pathology, Adana, Turkey
| | - Tamer Tetiker
- Cukurova University, Faculty of Medicine, Division of Endocrinology, Adana, Turkey
| |
Collapse
|
6
|
Pediatric trigger thumb caused by a flexor tendon sheath ganglion. J Pediatr Orthop B 2020; 29:203-205. [PMID: 30395001 DOI: 10.1097/bpb.0000000000000561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pediatric trigger thumb is a common reason for toddlers to present to a pediatric orthopaedic surgeon. There is controversy over the precise etiology and optimal treatment method. Current accepted diagnostic and treatment algorithms in children have not varied based on etiology. This report describes the clinical presentation and care of a 3-year-old child with pediatric trigger thumb and surgical findings of a large flexor tendon sheath ganglion at the level of the annular pulley with no apparent nodule within the FPL. The potential implications for consideration of etiology in current diagnostic and treatment guidelines are discussed.
Collapse
|
7
|
Jang Y, Kang BS, Bang M, Lim S, Park GM, Lee TY, Kwon WJ. Ganglion cysts developed from the flexor tendon sheaths in the fingers: Clinical and sonographic features. JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:9-13. [PMID: 31774183 DOI: 10.1002/jcu.22793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/23/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE The purpose of this study was to assess the clinical and sonographic features of flexor tendon sheath ganglion cysts in the fingers. METHODS We retrospectively reviewed the clinical and sonographic features of 35 cases of flexor tendon sheath ganglion cysts in the fingers in 34 patients that were pathologically confirmed between 2003 and 2018. RESULTS The mean age of the patients was 44.2 years (range, 11-73 years). Lesions were located at the level of the metacarpophalangeal joint (n = 22 [63%]) and proximal phalanx (n = 11 [31%]), and involvement of the third finger was common (n = 19 [54%]). The mean lesion size was 6 mm and the mean volume was 90 mm3 . None of the lesions had a pedicle. Lesions were homogeneous (n = 24 [69%]) and anechoic (n = 23 [66%]). A septum was noted in 12 cases (34%). CONCLUSIONS Flexor tendon sheath ganglion cysts are most commonly located in the third finger and at the level of the metacarpophalangeal joint and proximal phalanx. It usually presents as a simple cyst without a pedicle, but occasionally exhibits a mixed echogenicity and contains a septum.
Collapse
Affiliation(s)
- Yeonjung Jang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Byeong S Kang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Minseo Bang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Soyeoun Lim
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Gyeong M Park
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Tae Y Lee
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| | - Woon J Kwon
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea
| |
Collapse
|
8
|
|
9
|
Lavalette D, Giddins G. The Outcome of Treatment of Flexor Sheath (seed) Ganglia by a Percutaneous Partial Pulley Release. J Hand Surg Asian Pac Vol 2017; 22:219-221. [PMID: 28506163 DOI: 10.1142/s0218810417500289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aims of this study were to assess the safety and efficacy of a technique of partial percutaneous pulley release. METHODS A retrospective cohort study was undertaken treating adults with seed ganglia with a percutaneous pulley release. The patients were reviewed independently after a mean of 6 (range 6-36) months. RESULTS We treated 24 patients over a 3 year period. There were 14 women and ten men. The mean age was 39 (range 17-65) years. We were able to assess 21 patients with long term follow up. There was complete resolution in 14 (2/3) and partial resolution in four. The remaining three patients had persisting symptoms and requested open surgical excision. Apart from local tenderness and failure of resolution there were no complications of percutaneous pulley release. CONCLUSIONS Bursting or aspiration of flexor sheath ganglia appears to be the best primary treatment. If the ganglion recurs, this study suggests a percutaneous release is safe and will resolve the symptoms in most patients.
Collapse
Affiliation(s)
- David Lavalette
- 1 Department of Orthopaedic Surgery, Royal United Hospital, Bath, United Kingdom
| | - Grey Giddins
- 1 Department of Orthopaedic Surgery, Royal United Hospital, Bath, United Kingdom
| |
Collapse
|
10
|
Ahmad Z, Dickenson E, Tsakonas D. Misdiagnosis of trigger finger? Flexor seed ganglion masquerading as closed FDS rupture. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-013-0877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Finsen V, Håberg O, Borchgrevink GE. Surgery for ganglia of the flexor tendon sheath. Orthop Rev (Pavia) 2013; 5:e6. [PMID: 23705064 PMCID: PMC3662258 DOI: 10.4081/or.2013.e6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 01/02/2013] [Accepted: 01/07/2013] [Indexed: 11/22/2022] Open
Abstract
There are very few reports in the literature on the results of surgery for ganglia of the flexor tendon sheaths of the digits. We reviewed 24 patients operated for flexor tendon sheath ganglia 8 (3-11) years previously. Two operations were for recurrences and one of these recurred again. There was one permanent digital nerve injury and one patient complained of cold sensibility. VAS (0=best; 100=worst) for mean general complaints from the hand was remembered as 51 before surgery and was 5 at review. Mean pain at review was reported as VAS 4 and general satisfaction with the operation as VAS 3. All stated that they would have consented to surgery if they had known the outcome in advance. We conclude that the results of surgery are good, although complications do occur.
Collapse
Affiliation(s)
- Vilhjalmur Finsen
- Department of Orthopaedic Surgery, St. Olav's University Hospital; ; Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | |
Collapse
|
12
|
Rollins KE, Ollivere BJ, Johnston P. PREDICTING SUCCESSFUL OUTCOMES OF WRIST AND FINGER GANGLIA. HAND SURGERY 2013; 18:41-4. [PMID: 23413848 DOI: 10.1142/s021881041350007x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Ganglia are the commonest cause of swellings of the hand and wrist; the documented success of outcomes varies considerably. There is little published data to help predict patients likely to benefit from each treatment modality. We sought to identify factors predicting success of each intervention to provide an evidence basis to inform referral criteria and treatment decisions. Materials and Methods: A retrospective series of 140 serial patients referred with confirmed hand and wrist ganglia between June 2005 and January 2011 was studied to a minimum of 12-month follow-up to determine predictors of successful treatment. Treatment was deemed to be successful if the patient did not develop recurrence. Analysis was completed for predictors of successful treatment at presentation; examining gender, presence of pain, duration of symptoms, anatomic location and treatment modality. Results: Treatment success rate following aspiration was 34% for wrist and 58% for finger ganglia and for surgical excision 7% for wrist and 4% for finger ganglia. Surgical excision was significantly more successful than aspiration (p < 0.01). Duration of symptoms greater than one year was significantly associated with increased recurrence rates (relative risk 2.33, p < 0.05) and male sex was associated with lower recurrence (relative risk: 0.54, p = 0.14). Subgroup analysis of different varieties of soft tissue ganglia did not show any statistically significant factors predictive of recurrence, although both painless presentation and male sex were of borderline significance. Discussion and Conclusions: Duration of symptoms less than one year and male sex can be used to identify patients likely to benefit from interventional treatments and guide treatment decisions. Surgical excision was significantly more successful than aspiration (p < 0.01).
Collapse
Affiliation(s)
- K. E. Rollins
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - B. J. Ollivere
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - P. Johnston
- Department of Trauma and Orthopaedics, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| |
Collapse
|
13
|
|
14
|
Foret AL, Chhabra AB. Volar retinacular ganglions. J Hand Surg Am 2012; 37:566-7. [PMID: 21705156 DOI: 10.1016/j.jhsa.2011.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 05/07/2011] [Indexed: 02/02/2023]
Affiliation(s)
- Andrew L Foret
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA
| | | |
Collapse
|
15
|
Vanhoenacker FM, Eyselbergs M, Van Hul E, Van Dyck P, De Schepper AM. Pseudotumoural soft tissue lesions of the hand and wrist: a pictorial review. Insights Imaging 2011; 2:319-333. [PMID: 22347956 PMCID: PMC3259322 DOI: 10.1007/s13244-011-0076-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 11/27/2010] [Accepted: 01/27/2011] [Indexed: 12/26/2022] Open
Abstract
Mimickers of soft tissue tumours in the hand and wrist are more frequent than true neoplastic lesions. Pseudotumours belong to a large and heterogeneous group of disorders, varying from normal anatomical variants, cystic lesions, post-traumatic lesions, skin lesions, inflammatory and infectious lesions, non-neoplastic vascular lesions, metabolic disorders (crystal deposition disease and amyloidosis) and miscellaneous disorders. Although the imaging approach to pseudotumoural lesions is often very similar to the approach to “true” soft tissue tumoral counterparts, further management of these lesions is different. Biopsy should be performed only in doubtful cases, when the diagnosis is unclear. Therefore, the radiologist plays a pivotal role in the diagnosis of these lesions. Awareness of the normal anatomy and existence and common imaging presentation of these diseases, in combination with relevant clinical findings (clinical history, age, location and skin changes), enables the radiologist to make the correct diagnosis in most cases, thereby limiting the need for invasive procedures.
Collapse
Affiliation(s)
- Filip M. Vanhoenacker
- Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Rooienberg, 25, B-2570 Duffel, Belgium
- Department of Radiology, Antwerp University Hospital UZA, University of Antwerp UA, Wilrijkstraat, 10, 2650 Edegem, Belgium
| | - Michiel Eyselbergs
- Department of Radiology, AZ Sint-Maarten, Duffel-Mechelen, Rooienberg, 25, B-2570 Duffel, Belgium
- Department of Radiology, Antwerp University Hospital UZA, University of Antwerp UA, Wilrijkstraat, 10, 2650 Edegem, Belgium
| | - Erik Van Hul
- Department of Radiology, Antwerp University Hospital UZA, University of Antwerp UA, Wilrijkstraat, 10, 2650 Edegem, Belgium
| | - Pieter Van Dyck
- Department of Radiology, Antwerp University Hospital UZA, University of Antwerp UA, Wilrijkstraat, 10, 2650 Edegem, Belgium
| | - Arthur M. De Schepper
- Department of Radiology, Antwerp University Hospital UZA, University of Antwerp UA, Wilrijkstraat, 10, 2650 Edegem, Belgium
| |
Collapse
|
16
|
Pseudotumoral ganglion cyst of a finger with unexpected remote origin: multimodality imaging. Skeletal Radiol 2010; 39:375-9. [PMID: 19894046 DOI: 10.1007/s00256-009-0816-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 09/22/2009] [Accepted: 10/01/2009] [Indexed: 02/02/2023]
Abstract
The case of a ganglion cyst in the pulp of a fifth finger in an elderly woman initially mimicking a soft tissue tumor is described. Most typical sites of ganglion cysts are well documented at the wrist and in the vicinity of inter-phalangeal and metacarpo-phalangeal joints. In this case, ultrasonography (US) and magnetic resonance imaging (MRI) demonstrated a cystic lesion within the pulp of the fifth finger and indicated carpal osteoarthritis as the distant-and unexpected-origin of the lesion. The suggested diagnosis of ganglion cyst was confirmed by computed tomography arthrography (CT arthrography) of the wrist, which showed opacification of the cyst on delayed acquisitions after intra-articular injection into the mid-carpal joint, through the fifth flexor digitorum tendon sheath. The communications between the degenerative carpal joint, the radio-ulnar bursa, the fifth flexor digitorum tendon sheath and the pedicle of the cyst were well demonstrated.
Collapse
|
17
|
Suresh SS, Rani V. Fibrous flexor sheath ganglion and trigger thumb in a 14-year-old female. Indian J Plast Surg 2009; 42:134-5. [PMID: 19881040 PMCID: PMC2772295 DOI: 10.4103/0970-0358.53029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- S S Suresh
- Ibri Regional Referral Hospital, PO Box 46, Ibri 516, Oman
| | | |
Collapse
|